Study finds youth and caregivers often disagree on teen mental health diagnoses

Disagreement is the norm in assessments

A new analysis of data from the Adolescent Brain Cognitive Development study examined reports from 11,868 youth aged nine to 17 and their caregivers. The researchers derived diagnoses based on the DSM-5 using separate interviews for each informant. Upon reporting a diagnosis, data originated from a single source in roughly 65 to 98 percent of instances, varying by the particular condition. This pattern indicates that disagreement is the standard rather than an exception during clinical evaluations.

Specific conditions show distinct reporting patterns

In contrast to their parents, adolescents reported higher rates of major depressive disorder, sleep issues, substance use, and suicidal ideation. Conversely, caregivers were more likely to identify conduct disorders, eating disorders and generalized or social anxiety disorders in the children. Agreement between the two groups generally improved as the adolescents grew older but remained limited throughout adolescence. These discrepancies persist across different developmental stages and influence how prevalence estimates are calculated for psychiatric disorders.

Authors urge asking both informants

Lead author Laika D Aguinaldo stated that parents often do not know their children are experiencing these specific mental health problems. She noted that consulting just a single individual could overlook the chance to spot a youth requiring assistance before it is too late. Future work will investigate factors associated with these discrepancies and whether they influence access to mental health services or clinical outcomes.